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21 Comments

Hello All,
I have a question. I am going thru a difficult process with my implants. I had 2 root canals fail on tooth #12. After the second root canal failed about a week later (had pain in tooth, either infection or other) i started to look into implants. When i found a implant doctor he did a 3-D scan of my teeth. He found that #12 was cracked at the tooth and had to come out. So he began to give me options. I should mention that i dont have teeth #13, & #14. I lost them about 7-10 years ago. So he wanted to do a bridge. So he suggested that to place a implant on #12 & #14 and place Bone grafting in the area of #13. I originally wanted #12 to be taken out right away since it bothered me alot. Then let it heal and come back a few months later. He suggested to save time by extracting the #12 tooth and placing a implant that same day and also place a implant on #14. Well a few weeks later the implant #12 got infected (#14 is ok). Well i went in for surgery to get the implant replaced. He said he found the problem and replaced the implant that same day with a smaller one. I lost some of my gums that day, well they receded a bit. But now about 10 weeks later my natural tooth #11 is starting to hurt. It feels sore and aches. Im worried that the tooth is shifting or the root is affected by the implant installed at #12. Btw, i only have the implants i have yet to install the crowns (still healing process). Im going to the implant surgeon here in the two days. Although im thinking about requesting to get the implant #12 taken out since all it has done it caused me pain. Im really worried that now i have perminant damage.

Below is the dates for reference:
Surgery for extraction and placed implants on #12, #14, and bone grafting on #13 was on August 27.
Replaced #12 implant on Nov 11 with a smaller implant.

Hi Jesse,
I am sorry that you are having difficultiess with the implant treatment you have received.
Everything you have described is within normal implant practices, although some dentists prefer to extract the tooth and let the area heal first in the case where there may be infection in the site. If the implant was placed without removing all the infection and infected tissues, that could cause it to fail.
I do not know why the implant would be replaced with a smaller one, unless it was too big to begin with.
The natural tooth #11 can start to hurt if it was traumatized by the placement of the implant or if it is being traumatized by heavy occlusion (biting forces) since it is the last tooth present and you have no back molars to share the load.
the suggestion to place implants in 12 and 14 seems the logical one since you need molars to bite with and it is not recommended to have a bridge supported by an implant and a natural tooth if you can avoid it.
If you are not confident that you are getting the correct treatment, you can seek a second opinion from an experienced implant dentist in your area. Only a dentist that looks in your mouth and has the necessary records can give you that.
I hope this helps, and good luck!

THANK YOU FOR YOUR PROMPT RESPONSE (a sunday ).I AM NOT YOUR USUAL DENTAL PATIENT,ACTUALLY I’AM SENSITIVE TO ANY CHANGE IN MY MOUTH.I HAVE ISSUES THAT OTHER PEOPLE DEAL WITH OR NOT EVEN GIVE IT A THOUGHT. SO IN YOUR OPINION IS THERE A SOLUTION TO EASE THIS PRESSURE I FEEL”VERY THIGHT” THANKS AGAIN,SANDY BALDI

HI ,I JUST HAD AN IMPLANT ON TOOTH #7. IT HAD A POST AND IT WAS CRACKED. I HAD IT ON MARCH 6TH. THE DR. PULLED MY TOOTH ADDED SOMETYPE OF BONE AND PUT A STICH IN.WILL HAVE A FOLLOW UP ON MARCH 14TH. I HAVE NO SWELLING PAIN OR NUMBNESS. THE BIG TOOTH NEXT TO 7 IS MY NATURAL HEALTHY TOOTH WHICH WAS PERFECT. NOW IT FEELS FAKE LIKE THE IMPLANT TOOTH. WILL THIS FEEL NORMAL I THINK THE SCREW PLACEMENT IS CAUSING THE SENSATION. iAM VERY UPSET AND ANXIOUS .I KNOW IT NEEDS TIME FOR HEALING ,BUT IS THAT NORMAL AND WHEN WILL PRESSURE FEELING GO AWAY? THANKS FOR YOUR ANSWER. SANDY BALDI

Hi SB,
I am glad to see that you do not have any pain or swelling in the area of the implant.
There should be no bad sensation on the adjacent teeth after placing the implant. Sometimes if there is very little room between the adjacent teeth, the implant can touch or even damage one of the roots if it is not carefully placed. This would be evident in an x-ray of the implant.
Instead of speculating what might have happened, you should call the dentist and explain your symptoms and your concerns. Maybe he can show you the x-ray and give you a good explanation.
If you are still not satisfied with the explanation, then consider going to an experienced implant dentist for a second opinion.
I hope everything turns out well for you.

Dear Nissanka:
The answer depends on many things.
For example, If the teeth were lost very recently and bone is still not present in the socket, then you would not be able to get enough implant stability at the time the implants are placed.
You also have to take into account that the implants will be placed in the cosmetic zone, and any ridge deficiencies in height and width caused by the remodeling of bone after an extraction can make a succesful implant surgery be a cosmetic failure after it is restored.
Finally, the canine is subjected to lateral forces during normal function that may be ok for a regular diameter implant, but may be too much for a mini implant, even if you splint the two together.
My personal preference in a case like this is to use regular diameter implants and make sure that the tissues are adequate for stable long term results.
Thanks for your question and good luck!
Carlos Boudet, DDS, DICOI
Dentist in West Palm Beach, Floridahttp://www.boudetdds.com

Hi K J,
You have been informed that your dental implant is affected by a low grade infection called peri-implantitis that is slowly destroying the bone that supports your implant.

The surface of the implant is infected and contaminated by bacteria that will continue to destroy the bone unless it is removed.

There is treatment available for an ailing implant. The treatment consists of removal of the bacterial contamination and detoxification of the implant surface. The implant is exposed and the bacterial film and toxins on the implant surface and the infected soft tissues around the implant are removed. The surface is decontaminated by chemical and mechanical means, or in the case of Laser Treatment, an all tissue laser such as the Waterlase is used to clean and disinfect the implant surface . The area is covered with a dressing for about a week and normal gentle cleaning resumes after that.

Depending on the size and shape of the bone defect, the dentist may place a bone graft.

It is normal for the tissues to shrink after the surgery, so part of the abutment (post) or even the implant may be visible after healing.

In cases where access is simple, one surgical treatment may be all that is necessary but in more difficult cases more than one treatment may be necessary to get the infection under control.

It is very important to develop a good daily oral hygiene routine to keep the gums around your teeth and implants healthy, and to supplement that with regular checkup and maintenance appointments in the dentist’s office.

I am going to lose one of my two front teeth. It has a failed root canal and the root is cracked. Also it looks a lot longer than the other. I was told I need an implant, but I am afraid that after I get the implant, the tooth will look longer still. What can I do?
Thanks in advance for your help.

Dear G G:
When your two front teeth are a different size it detracts from your smile, so I agree that you should make every effort to correct that.
There are two options that are available to you to help you correct this situation.
The first option, and the one I prefer, is to use orthodontics to extrude the tooth. This stimulates the bone and gums to grow and will make the teeth the same size again. The process is called forced eruption and it is an excellent minimally invasive procedure to improve your situation. At the end of the forced eruption you can replace the tooth with an implant. This also minimizes the amount of grafting that you may need.
The other option is called a block graft and it requires a larger surgery to graft the deficient area before the implant is placed.
Forced eruption is definitely the preferred procedure generally.
Hope this helps, and good luck!!!
Carlos Boudet, DDS, DICOIhttp://www.boudetdds.com

Wonderful blog! I definitely love how it’s easy on my eyes and also the data are well written. I am wondering how I might be notified whenever a new post has been made. I have subscribed to your rss feed which need to do the trick! Have a nice day!

I lost a front tooth and the dentist grafted the area with a grafting material called Bio-oss. I have researched in the internet and some doctors don’t like the material.
It has been seven months after the graft and in the x-ray that the doctor took I can still see all the graft material. Am I going to be able to get an implant?
(please keep my e-mail private)

Dear Patty:
There are many different types of graft materials available today, and they are used mainly to prevent the normal bone loss that happens after an extraction, or to augment an area where the bone is deficient.
When you put a bone graft in an area where you will be placing an implant, you want the graft material to be totally replaced by your own bone.
Bio-Oss is a material that resorbs very little, so after 4 to 6 months when the area should be ready for the implant, it is still present in the healed site.
Bio-Oss is a graft material that has been used for many years and many doctors like it because it keeps the volume of the grafted area better than other materials that resorb quickly.
Since the slightest bone loss after an extraction of a front tooth can result in changes that may cause gum recession and affect the appearance of your teeth, the dentist probably felt safer using this material.
You should be able to place an implant in the area since there should be enough bone around the graft particles.
Thanks for sharing your question with us and Good luck!

Dear Lucy:
I probably should answer this in two parts.
The first part, the percentage of implant failure is very low, which means the success rate is very high. A success rate of 95 to 99% is seen in the literature.
The second part, which deals with the longevity of implants has more variables in it. Implants lasting twenty years are not uncommon, but an implant that has been clinically successful for many years can eventually fail if the routine conditions of good oral hygiene and regular professional care are not followed by the patient.
For the majority of cases, implants are very long lasting.
Carlos Boudet, DDS, DICOIhttp://www.boudetdds.com